Tulip vs Open Domes

I am USAF retired and have a service connected hearing loss. My high pitch hearing is exceptionally bad due to severe tinnitus. On the other end I have very good low pitch hearing. I have tried several types of hearing aids provided by the VA and until now they have all wound up stuffed in the drawer.

About a month ago they fitted me with Resound LINX2 hearing aids. They seem to be pretty good but the VA just seems clueless when setting them up and modifying the programming. For instance. I have been seeing where open domes would be better in my circumstance because they would let the low pitches in naturally and then the hearing aids would boost the highs. I have been fitted with tulips. The tulips are very uncomfortable but when I asked the VA to try the open domes they refused saying that it would be worse.

I have thought about just buying my own open domes and installing them but I would think that the hearing aids would require a program mod.

Any inputs would be appreciated.

Additionally, I have done a bunch of research and discovered that there are several settings that should be available on my app but I guess the VA doesnā€™t really know how to program them.

Can you post your audiogram?

Domes are cheap enough that if I were you Iā€™d just buy open domes to try out to see if they work better or not. Thereā€™s nothing to lose but a few bucks. If they work out better, a program mod to optimize it for open dome may help make it even better. But at least even if you canā€™t get a program mod because the VA donā€™t want to bother or whatever, at least if itā€™s still better than before even if not optimized, then itā€™s worth trying.

If you canā€™t get the VA to fit it for you properly, it may be worthwhile to pay a little bit to a local audi who can work with you better. Maybe the audi can bill the VA for the services as an out of network provider.

The aids do need to be programmed for the different domes. Each type requires different programming specific to that type of dome. I donā€™t think anyone can advise you without knowing what your level of loss is like.

Do you have a different VA office you could visit? Also - often audiologists donā€™t like to overload people with features and programs at first but if you go back and ask them to turn on the features you want for the app they should be able to help. If they donā€™t seem familiar with the particular aid then you could ask for a rep from the company to be arranged to be present at your session.

ā€œI have thought about just buying my own open domes and installing them but . . .ā€

Iā€™ve done that without the world coming to an end. Iā€™m programmed for closed but donā€™t seem to get any feedback with open on the same setting using Phonak v90s.

ā€” Updated ā€”

ā€œI have thought about just buying my own open domes and installing them but . . .ā€

Iā€™ve done that without the world coming to an end. Iā€™m programmed for closed but donā€™t seem to get any feedback with open on the same setting using Phonak v90s.

Throw them damn VA aids in the drawer with the others.

ā€” Updated ā€”

Throw them damn VA aids in the drawer with the others.

FYI, Jakey is a retired VA fitter. You can see it gets defensive about their services for some reason. Now that heā€™s retired, his main concern is keeping kids off his grass.

Kenjis main concern is following me on here I guess it getā€™s boring in the basement.

As to the OP it doesnā€™t seem like he wants to put any effort into getting his aids rightā€¦ as in tossed them in the drawer and these at least his third free pair arenā€™t suiting him either. Ask to speak with the dept chief they will more then likely get you an appt with their ā€˜aceā€™ fitter. They can bring in the Resound rep or pick up the phone and talk directly to Resound tech support. If on the long shot of getting no joy from the chief go to your patient advocate. Once the chief gets involved written status report are required to be filed until YOU agree the problem has been resolved. Remember you are not locked into Resound. The Oticon OPEns and the Signia Primax are available.

Congrats on finally offering useful info, Jakey.

My dad (Col., USAF ret.) and father-in-law (Lt.Col., USAF ret.) both go to the same VA clinic. Their audiograms donā€™t look much different.

My dad (with moderate dementia) hates his hearing aids, doesnā€™t use them (I doubt he can even find them), and says any time he tries to talk with his audiologist heā€™s told nothing useful and feels shut down.

My father-in-law (with significant dementia) loves his hearing aids, uses them consistently, and says his audiologist is very helpful and responsive. He loves the app on his iPhone, likes to tinker with his settings, and frequently uses the lost hearing aid finding function.

Oh, and at Costco (with a hearing aid fitter, not an audiologist), I found that I very much liked the tulip dome in my right ear using Resound Cala 8ā€™s (Costco-branded Linx2). The fitter thought Iā€™d need the closed domes but it made me feel as if I were in a bucket or had my finger in my ear every time I spoke. The tulip dome sounded much more natural to me. I got an open dome for my less-lousy left ear.

OP, it wouldnā€™t hurt to post your audiogram. You could copy the table below to your signature and fill in the blanks from your audiogram.

<tbody> </tbody>
125 250 750 1k 1.5k 2k 3k 4k 6k 8k
R ## ## ## ## ## ## ## ## ## ##
L ## ## ## ## ## ## ## ## ## ##

Your right ear is shown in Oā€™s and red (on a color printout) on the audiogram and your left ear in Xā€™s and blue. There may well be other markings, but those are the basics.

The OP ainā€™t been back since 12/14/16 so I suspect just another bullshit artist!

Now the tread has been hijacked into another Costco thread!

After reading this thread, Iā€™ll post my current and historical (since audiograms in sig lines will change)

2013

<tbody> </tbody>
125 250 500 1k 1.5k 2k 3k 4k 6k 8k
R ## 50 40 35 40 40 60 55 60 55
L ## 40 35 35 30 40 50 55 55 60
<tbody> </tbody>
125 250 500 1k 1.5k 2k 3k 4k 6k 8k
R ## 50 50 50 ## 55 65 60 55 55
L ## 45 45 45 45 65 55 60 60 65

I started with closed domes and they felt like fingers in the ears. Open felt better. Iā€™m not sure if that is because they look more flexible. Closed had somewhat of a tunnel sound.

Looking at pictures of Tulip domes, it seems that they might be described as closed domes with side vents. Is that a good analogy?

My new Audi says my new HA will be BTE with closed domes. Is that based soley on my recent audiogram?

Hereā€™s a good article on open and closed fittings. Open-Fit Hearing Instruments: Practical Fitting Tips | The Hearing Review
Basically, to get any amplification at low frequencies, one needs a more closed fitting. However, ultimately itā€™s up to you. If you canā€™t stand a closed fitting and wonā€™t wear the hearing aids, youā€™d get more benefit from a more open fitting. Itā€™s a balance between ā€œocclusionā€ and audibility.

fter reading this thread, Iā€™ll post my current and historical (since audiograms in sig lines will change)

2013

<tbody> </tbody>
125 250 500 1k 1.5k 2k 3k 4k 6k 8k
R ## 50 40 35 40 40 60 55 60 55
L ## 40 35 35 30 40 50 55 55 60
<tbody> </tbody>
125 250 500 1k 1.5k 2k 3k 4k 6k 8k
R ## 50 50 50 ## 55 65 60 55 55
L ## 45 45 45 45 65 55 60 60 65

I started with closed domes and they felt like fingers in the ears. Open felt better. Iā€™m not sure if that is because they look more flexible. Closed had somewhat of a tunnel sound.

Looking at pictures of Tulip domes, it seems that they might be described as closed domes with side vents. Is that a good analogy?

My new Audi says my new HA will be BTE with closed domes. Is that based soley on my recent audiogram?

Sorry if I offended. I did some poor editing and part of my comment ended up in the quote. (Since fixed)

[/quote]

No offence MDB. The ā€œfitting tipsā€ article you pointed to was quite informative. Thank you.

snevetsm: It would be interesting to know if there is any time-line link between your dadā€™s and father-in-lawā€™s dementia and when they finally bought their hearing aids. Iā€™ve read - and seen first-hand! - how dementia can set in if hearing issues arenā€™t addressed.

Also know first-hand many grumpy, senior HA wearers who refuse any kind of help with a key communication issue (i.e., hearing). Sometimes their issues begin with earwax build-up due to medications. If not addressed, it spirals out of control to complete inability to carry on conversations, withdrawal, anti-social behavior, and even sparring with their audiologists.

Considering how critical hearing is, itā€™s amazing to me how little attention, insurance and options are out there to correct the issue early-on.

Yes: closed domes do sound occluded. The open domes are a way of venting the aids - not unlike the vent holes in ITE-style aids (those with a hard plastic shell).

I like your description of the tulip dome. I had also tried them out on my Oticon Opn miniRITE aids for a few weeks, but due to my hearing loss, found they were TOO vented.

Itā€™s a process! I had also tried out foam domes that I bought at Amazon.com. They were SUPER comfy, but I couldnā€™t seem to get a proper seal, therefore could not hear on the phone AT ALL.

When at the audiologistā€™s yesterday, I brought a picture of a ā€œzip tipā€ - which Iā€™d read about right here on the forum. My aud-guy said heā€™d fit one patient who had an allergic reaction to the material used. So, that nixed THAT option.

I now have double-domes, size L, which seem to offer comfort, some breathability and still a good seal for better hearing.


The argument about which dome isnā€™t really that productive. The more severe the loss, the more closed the domes need to be. When one changes style, the aids need to be readjusted. It may not be what one wishes for but it is what it is.